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{{Chembox new
{{DrugProjectFormSinglePage
|   Name = Permethrin
|authorTag={{KS}}
|  ImageFile = Permethrin-2D-skeletal.png
|genericName=permethrin
|  ImageSize = 250px
|aOrAn=a
|  ImageName = Chemical structure of permethrin
|drugClass=dermatological agent
|  IUPACName =  3-Phenoxybenzyl<br />
|indicationType=treatment
(1RS)-cis,trans-3-(2,2-dichlorovinyl)<br />-2,2-dimethylcyclopropanecarboxylate<br />
|indication=[[scabies]], [[pediculosis capitis]]
| Section1 = {{Chembox Identifiers
|adverseReactions=[[pruritus]], [[erythema]], [[numbness]], [[tingling]], [[rash]], [[headache]], [[fever]], [[dizziness]], [[abdominal pain]], [[diarrhea]], [[nausea]] and [[vomiting]]
|  SMILES = c3ccccc3Oc(c2)cccc2COC(=O)<br />C1C(C1(C)C)C=C(Cl)Cl
|blackBoxWarningTitle=Warning Title
  }}
|blackBoxWarningBody=<i><span style="color:#FF0000;">Condition Name:</span></i> (Content)
| Section2 = {{Chembox Properties
|fdaLIADAdult===Indications==
|   Formula = C<sub>21</sub>H<sub>20</sub>Cl<sub>2</sub>O<sub>3</sub>
*Permethrin 5% Cream is indicated for the treatment of scabies caused by Sarcoptes scabiei
|   MolarMass = 391.28 g/mol
|   Density = 1.19 g/cm³, solid
|   Solubility = Insoluble (5.5 x 10<sup>-3</sup> [[Parts per million|ppm]])
|   Appearance = colourless crystals
|  MeltingPt = 34 °C (307 K)
|  BoilingPt = 200 °C (473 K)
  }}
| Section7 = {{Chembox Hazards
|  ExternalMSDS = [http://physchem.ox.ac.uk/MSDS/PE/permethrin.html External MSDS]
|  MainHazards = Irritating to skin and eyes,<br /> damaging to lungs
  }}
| Section8 = {{Chembox Related
|  Function = [[pyrethroid]]s
|  OtherFunctn = [[Bifenthrin]]<br />[[Deltamethrin]]
|  OtherCpds =
  }}
}}
'''Permethrin''' is a common [[chemical synthesis|synthetic]] chemical, widely used as an [[insecticide]] and [[acaricide]] and as an [[insect repellent]]. It belongs to the family of synthetic chemicals called [[pyrethroid]]s and functions as a [[neurotoxin]], affecting [[neuron]] [[cell membrane|membrane]]s by prolonging sodium channel activation.


==Uses==
==Dosage==
* Thoroughly massage Permethrin 5% Cream into the skin from the head to the soles of the feet. Scabies rarely infests the scalp of adults, although the hairline, neck, temple, and forehead may be infested in infants and geriatric patients. Usually 30 grams is sufficient for an average adult. The cream should be removed by washing (shower or bath) after 8 to 14 hours. Infants should be treated on the scalp, temple, and forehead. ONE APPLICATION IS GENERALLY CURATIVE.


In agriculture, Permethrin is mainly used on [[cotton]], [[wheat]], [[maize]], and [[alfalfa]] crops, and is also used to kill [[parasite]]s on [[chicken]]s and other [[poultry]]. Its use is controversial since, as a [[broad-spectrum]] chemical, it kills indiscriminately; as well as the intended pests, it can harm beneficial insects including [[honey bee]]s, aquatic life,<ref>{{cite journal | author = R. H. Ian | title = Aquatic organisms and pyrethroids | year = 1989 | journal = [[Pesticide Science]] | volume = 27 | issue = 4 | pages = 429-457 | doi = 10.1002/ps.2780270408}}</ref> and small mammals such as [[mouse|mice]].
* Patients may experience persistent pruritus after treatment. This is rarely a sign of treatment failure and is not an indication for retreatment. Demonstrable living mites after 14 days indicate that retreatment is necessary.
|offLabelAdultGuideSupport=There is limited information regarding <i>Off-Label Guideline-Supported Use</i> of Permethrin in adult patients.
|offLabelAdultNoGuideSupport===Indications and Dosing==


However, permethrin can be used in a targeted manner as well. This is the basis for a method of reducing populations of the [[deer tick]] ''Ixodes scapularis'' (''I. dammini''). Biodegradable cardboard tubes stuffed with permethrin-treated cotton, are sold under the brand name ''Damminix'',<ref>{{cite web | title = Damminix Tick Tubes (Official site) | url = http://www.ticktubes.com/}}</ref> Mice collect the cotton for lining their nests, and the pesticide on the cotton kills any immature ticks that are feeding on the mice.<ref name="Property Protection">{{Cite web | title = Lyme disease and related tick-borne infections | url = http://www.umm.edu/patiented/articles/how_can_lyme_disease_other_tick-borne_infections_be_prevented_000016_8.htm  | date = 18 Jan 07 | publisher = University of Maryland Medical Center}}</ref>
* Pediculosis capitis: apply to damp hair that has just been shampooed with a non conditioning shampoo; saturate hair and scalp beginning behind the ears and at back of neck; leave on 10 minutes; rinse with warm water; remove nits with nit comb; repeat application if live lice present 7 days after initial treatment.


Permethrin is also used in healthcare, to eradicate parasites such as [[head lice]] and mites responsible for [[scabies]], and in industrial and domestic settings to control pests such as [[ant]]s and [[termite]]s.
* Scabies: apply a generous amount of cream from head to feet, leave on for 8 to 14 hours, wash with soap/water, repeat application if living mites present 14 days after initial treatment.
|fdaLIADPed===Indications==
* Permethrin 5% Cream is indicated for the treatment of scabies caused by Sarcoptes scabiei.


Permethrin kills ticks on contact with treated clothing. According to the [[Connecticut Department of Public Health]], it "has low mammalian toxicity, is poorly absorbed through the skin and is rapidly inactivated by the body. Skin reactions have been uncommon."<ref>{{cite web | url = http://www.dph.state.ct.us/BCH/infectiousdise/tickborne/tick.htm#Permethrin | title = Tick Bite Prevention | author = Kirby C. Stafford III | date = Feb 1999 | publisher = Connecticut Department of Public Health}}</ref>
==Dosing==


Permethrin is used in tropical areas to prevent [[mosquito]]-borne disease such as [[Dengue fever]] and [[malaria]]. Mosquito nets used to cover beds may be treated with a solution of permethrin. Military personnel training in malaria-endemic areas may be instructed to treat their uniforms with permethrin as well. An application should last several washes.
* Safety and efficacy have not been established in pediatric patients 2 months or younger.


Recently, in [[South Africa]], residues of permethrin were found in breast milk, together with DDT, in an area that experience [[DDT]] treatment for malaria control, as well as the use of pyrethroids in small-scale agriculture.<ref>{{cite journal | author = H. Bouwman, B. Sereda and H. M. Meinhardt | title = Simultaneous presence of DDT and pyrethroid residues in human breast milk from a malaria endemic area in South Africa | year = 2006 | journal = [[Environmental Pollution]] | volume = 144 | issue = 3 | pages = 902-917 | doi = 10.1016/j.envpol.2006.02.002}}</ref>
* Thoroughly massage Permethrin 5% Cream into the skin from the head to the soles of the feet. Scabies rarely infests the scalp of adults, although the hairline, neck, temple, and forehead may be infested in infants patients. The cream should be removed by washing (shower or bath) after 8 to 14 hours. Infants should be treated on the scalp, temple, and forehead. ONE APPLICATION IS GENERALLY CURATIVE.


==Products containing permethrin==
* Patients may experience persistent [[pruritus]] after treatment. This is rarely a sign of treatment failure and is not an indication for retreatment. Demonstrable living mites after 14 days indicate that retreatment is necessary.
Products containing 0.5% permethrin:
|offLabelPedGuideSupport=There is limited information regarding <i>Off-Label Guideline-Supported Use</i> of Permethrin in pediatric patients.
|offLabelPedNoGuideSupport===Indications and Dosage==


* [[Repel Permanone]]
* Safety and efficacy have not been established in pediatric patients 2 months or younger.
*
* [[Permethrin Tick Repellent]]


* Bonide Ant Dust (0.25%)
* Pediculosis capitis: apply to damp hair that has just been shampooed with a non conditioning shampoo; saturate hair and scalp beginning behind the ears and at back of neck; leave on 10 minutes; rinse with warm water; remove nits with nit comb; repeat application if live lice present 7 days after initial treatment.


* Nix 1% shampoo for [[head lice]].
* Scabies: apply a generous amount of cream from head to feet, leave on for 8 to 14 hours, wash with soap/water, repeat application if living mites present 14 days after initial treatment.
|contraindications=* Permethrin 5% Cream is contraindicated in patients with known [[hypersensitivity]] to any of its components, to any synthetic pyrethroid or pyrethrin.
|warnings=There is limited information regarding <i>Warnings</i> of Permethrin in patients.
|clinicalTrials=* In clinical trials, generally mild and transient burning and stinging followed application with permethrin 5% Cream in 10% of patients and was associated with the severity of infestation. [[Pruritus]] was reported in 7% of patients at various times post-application. [[Erythema]], [[numbness]], [[tingling]], and [[rash]] were reported in 1 to 2% or less of patients.
|postmarketing=* Other adverse events reported since marketing Permethrin 5% Cream include: [[headache]], [[fever]], [[dizziness]], [[abdominal pain]], [[diarrhea]] and [[nausea]] and/or [[vomiting]]. Although extremely uncommon and not expected when used as directed , rare occurrences of seizure have been reported. None have been medically confirmed as associated with Permethrin™ treatment.
|drugInteractions=There is limited information regarding <i>Drug Interactions</i> of Permethrin in patients.
|othersTitle=Others
|administration='''Topical'''


* [[Elimite]] 5% skin cream or generic equilvalent for [[scabies]], [[lice]], [[head lice]], [[bird mites]], [[tropical rat mites]], [[bed bugs]], and other [[mites]].
* Shake bottle well prior to use.


* Most [[flea]] and tick repellant for dogs (Adams, Bio-Spot, K9-Advantix, Cutter)
* Do not use near eyes, inside the nose, mouth, or vagina; protect eyes with a washcloth or towel during application.
* (Permethrin 1%) apply to damp hair that has just been shampooed with a nonconditioning shampoo; saturate hair and scalp beginning behind the ears and at back of neck; leave on 10 minutes; rinse with warm water; remove nits with nit comb;
* Repeat application if live lice present 7 days after initial treatment.
* (Permethrin 1%) do not rewash hair for 1 to 2 days after treatment.
* (Permethrin 5% cream) apply a generous amount of cream from head to feet, leave on for 8 to 14 hours, wash with soap/water, repeat application if living mites present 14 days after initial treatment.
|monitoring=* Presence of lice
|overdose=* No instance of accidental ingestion of Permethrin™ (permethrin) 5% Cream has been reported. If ingested, gastric lavage and general supportive measures should be employed. Excessive topical use may result in increased irritation and [[erythema]].
|drugBox=[[File:Permethrin wiki structure.png|thumb|none|600px|This image is provided by the National Library of Medicine.]]
|mechAction=* It acts on the nerve cell membrane to disrupt the sodium channel current by which the polarization of the membrane is regulated. Delayed repolarization and paralysis of the pests are the consequences of this disturbance.


* Dragnet, a pesticide for home use, also contains permethrin.
* Permethrin is rapidly metabolized by ester hydrolysis to inactive metabolites which are excreted primarily in the urine. Although the amount of permethrin absorbed after a single application of the 5% cream has not been determined precisely, data from studies with 14C-labeled permethrin and absorption studies of the cream applied to patients with moderate to severe scabies indicate it is 2% or less of the amount applied.
|structure=* Permethrin™ (permethrin) 5% Cream is a topical scabicidal agent for the treatment of infestation with Sarcoptesscabiei (scabies). It is available in an off-white, vanishing cream base. Permethrin™ (permethrin) 5% Cream is for topical use only.


* Raid Ant and Roach killer, another home insecticide contains 2% permethrin.
[[File:permethrin01.png|thumb|none|600px|This image is provided by the National Library of Medicine.]]


* [[Cutter]] Bug Free Backyard
<BR>
Products containing 12.6% permethrin:


* [[Raid (insecticide)|Raid]] fumigator
'''Chemical Name''' - The permethrin used is an approximate 1:3 mixture of the cis and trans isomers of the pyrethroid 3-(2,2-dichloroethenyl)-2,2-dimethylcyclopropanecarboxylic acid, (3-phenoxyphenyl) methyl ester. Permethrin has a molecular formula of C21H20Cl2O3 and a molecular weight of 391.29. It is a yellow to light orange-brown, low melting solid or viscous liquid.


==Stereochemistry==
'''Active Ingredient''' - Each gram contains permethrin 50 mg (5%).
Permethrin has four [[Stereoisomerism|stereoisomers]] (two [[enantiomer|enantiomeric pairs]]), arising from the two [[stereocenter|stereocentres]] in the [[cyclopropane]] ring.  The ''[[trans]]'' enantiomeric pair is known as '''transpermethrin'''.


<gallery>
'''Inactive Ingredients''' - Butylated hydroxytoluene, carbomer homopolymer type B, fractionated coconut oil, glycerin, glyceryl monostearate, isopropyl myristate, lanolin alcohols, mineral oil, polyoxyethylene cetyl ethers, purified water, and sodium hydroxide. Formaldehyde 1 mg (0.1%) is added as a preservative.
Image:Biopermethrin-2D-skeletal.png|<center>''(1R)''-''trans''-acid moiety, known as '''biopermethrin'''</center>
|PK='''Absorption'''
Image:(1S)-trans-permethrin.svg|<center>''(1S)''-''trans''-acid moiety</center>
Topical: 2% or less absorbed.
Image:Cis-permethrin-A-2D-skeletal.png |<center>one ''cis'' [[enantiomer]]</center>
Image:Cis-permethrin-B-2D-skeletal.png |<center>the other ''cis'' enantiomer</center>
</gallery>


==Toxicity==
'''Excretion'''
Permethrin is extremely toxic to fish. Extreme care must be taken when using products containing permethrin near water sources.
Permethrin is also highly toxic to cats. Flea and tick repellent formulas intended (and labeled) for dogs may contain permethin and cause feline permethrin toxicosis in cats: specific flea and tick control formulas intended for feline use, such as those containing [[fipronil]], should therefore be used for cats instead.


Currently, permethrin is not considered a carcinogen by any recognized authoritative body, but a few studies have lead the US EPA to classify the substance as a Category C carcinogen: Possible human carcinogen (the data show limited evidence of carcinogenicity in the absence of human data)<ref>[http://www.pested.psu.edu/infocenter/issues/fqpacanctab.pdf]US EPA List of Chemicals Evaluated for Carcinogenic Potential</ref>. Carcinogenic action in nasal mucosal cells for inhalation exposure is suspected due to observed genotoxicity in human tissue samples, and in rat livers the evidence of increased preneoplastic lesions lends concern over oral exposure.<ref>{{cite journal | author = M. Tisch, P. Schmezer, M. Faulde, A. Groh and H. Maier | title = Genotoxicity studies on permethrin, DEET and diazinon in primary human nasal mucosal cells | year = 2002 | journal = [[European Archives of Oto-Rhino-Laryngology]] | volume = 259 | issue = 3 | pages = 150-153 | doi = 10.1007/s004050100406}}</ref><ref>{{cite journal | author = K. Hakoi, R. Cabral, T. Hoshiya, R. Hasegawa, T. Shirai and N. Ito | title = Analysis of carcinogenic activity of some pesticides in a medium-term liver bioassay in the rat | year = 1992 | journal = [[Teratogenesis, Carcinogenesis, and Mutagenesis]] | volume = 12 | issue = 6 | pages = 269-276 | doi = 10.1002/tcm.1770120605}}</ref> However, these results are seen as preliminary and marginal, at best.
Topical: Renal.
|howSupplied=Permethrin™ 5% Cream is available as follows:


==References==
60 g tube (NDC 40076-115-60)
<references/>
|storage=* Store at 20-25°C (68-77°F) [see USP Controlled Room Temperature].
 
|alcohol=Alcohol-Permethrin interaction has not been established. Talk to your doctor about the effects of taking alcohol with this medication.
==See also==
|brandNames=Permethrin™
* [[Methoprene]]
|nlmPatientInfo=(Link to patient information page)
 
|drugShortage=Drug Shortage
==External links==
}}
* [http://npic.orst.edu/factsheets/permethrin.pdf Permethrin Fact Sheet - National Pesticide Information Center]
{{LabelImage
* [http://npic.orst.edu/hottopic/PermethrinTreatedClothes.pdf Permethrin-treated Clothing Hot Topic - National Pesticide Information Center]
|fileName=Permethrin ingredients and appearance.png
* [http://extoxnet.orst.edu/pips/permethr.htm Permethrin Pesticide Information Profile - Extension Toxicology Network]
}}
* [http://www.alanwood.net/pesticides/permethrin.html Permethrin chemical data]
{{LabelImage
* [http://www.therossendalefreepress.co.uk/news/s/212/212931_firm_fined_over_irwell_pollution.html Example of permethrin river poisoning]
|fileName=Permethrin fig02.jpg
 
}}
{{Ectoparasiticides}}
{{LabelImage
 
|fileName=Permethrin fig01.jpg
[[Category:Antiparasitic agents]]
}}
[[Category:Household chemicals]]
[[Category:Organochlorides]]
[[Category:Phenol ethers]]
[[Category:Pyrethroids]]


[[de:Permethrin]]
[[Category:Drug]]
[[fr:Perméthrine]]
[[it:Permetrina]]
[[nl:Permethrin]]
[[fi:Permetriini]]

Latest revision as of 18:50, 9 March 2015

Permethrin
Adult Indications & Dosage
Pediatric Indications & Dosage
Contraindications
Warnings & Precautions
Adverse Reactions
Drug Interactions
Use in Specific Populations
Administration & Monitoring
Overdosage
Pharmacology
Clinical Studies
How Supplied
Images
Patient Counseling Information
Precautions with Alcohol
Brand Names
Look-Alike Names

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Kiran Singh, M.D. [2]

Disclaimer

WikiDoc MAKES NO GUARANTEE OF VALIDITY. WikiDoc is not a professional health care provider, nor is it a suitable replacement for a licensed healthcare provider. WikiDoc is intended to be an educational tool, not a tool for any form of healthcare delivery. The educational content on WikiDoc drug pages is based upon the FDA package insert, National Library of Medicine content and practice guidelines / consensus statements. WikiDoc does not promote the administration of any medication or device that is not consistent with its labeling. Please read our full disclaimer here.

Overview

Permethrin is a dermatological agent that is FDA approved for the treatment of scabies, pediculosis capitis. Common adverse reactions include pruritus, erythema, numbness, tingling, rash, headache, fever, dizziness, abdominal pain, diarrhea, nausea and vomiting.

Adult Indications and Dosage

FDA-Labeled Indications and Dosage (Adult)

Indications

  • Permethrin 5% Cream is indicated for the treatment of scabies caused by Sarcoptes scabiei

Dosage

  • Thoroughly massage Permethrin 5% Cream into the skin from the head to the soles of the feet. Scabies rarely infests the scalp of adults, although the hairline, neck, temple, and forehead may be infested in infants and geriatric patients. Usually 30 grams is sufficient for an average adult. The cream should be removed by washing (shower or bath) after 8 to 14 hours. Infants should be treated on the scalp, temple, and forehead. ONE APPLICATION IS GENERALLY CURATIVE.
  • Patients may experience persistent pruritus after treatment. This is rarely a sign of treatment failure and is not an indication for retreatment. Demonstrable living mites after 14 days indicate that retreatment is necessary.

Off-Label Use and Dosage (Adult)

Guideline-Supported Use

There is limited information regarding Off-Label Guideline-Supported Use of Permethrin in adult patients.

Non–Guideline-Supported Use

Indications and Dosing

  • Pediculosis capitis: apply to damp hair that has just been shampooed with a non conditioning shampoo; saturate hair and scalp beginning behind the ears and at back of neck; leave on 10 minutes; rinse with warm water; remove nits with nit comb; repeat application if live lice present 7 days after initial treatment.
  • Scabies: apply a generous amount of cream from head to feet, leave on for 8 to 14 hours, wash with soap/water, repeat application if living mites present 14 days after initial treatment.

Pediatric Indications and Dosage

FDA-Labeled Indications and Dosage (Pediatric)

Indications

  • Permethrin 5% Cream is indicated for the treatment of scabies caused by Sarcoptes scabiei.

Dosing

  • Safety and efficacy have not been established in pediatric patients 2 months or younger.
  • Thoroughly massage Permethrin 5% Cream into the skin from the head to the soles of the feet. Scabies rarely infests the scalp of adults, although the hairline, neck, temple, and forehead may be infested in infants patients. The cream should be removed by washing (shower or bath) after 8 to 14 hours. Infants should be treated on the scalp, temple, and forehead. ONE APPLICATION IS GENERALLY CURATIVE.
  • Patients may experience persistent pruritus after treatment. This is rarely a sign of treatment failure and is not an indication for retreatment. Demonstrable living mites after 14 days indicate that retreatment is necessary.

Off-Label Use and Dosage (Pediatric)

Guideline-Supported Use

There is limited information regarding Off-Label Guideline-Supported Use of Permethrin in pediatric patients.

Non–Guideline-Supported Use

Indications and Dosage

  • Safety and efficacy have not been established in pediatric patients 2 months or younger.
  • Pediculosis capitis: apply to damp hair that has just been shampooed with a non conditioning shampoo; saturate hair and scalp beginning behind the ears and at back of neck; leave on 10 minutes; rinse with warm water; remove nits with nit comb; repeat application if live lice present 7 days after initial treatment.
  • Scabies: apply a generous amount of cream from head to feet, leave on for 8 to 14 hours, wash with soap/water, repeat application if living mites present 14 days after initial treatment.

Contraindications

  • Permethrin 5% Cream is contraindicated in patients with known hypersensitivity to any of its components, to any synthetic pyrethroid or pyrethrin.

Warnings

There is limited information regarding Warnings of Permethrin in patients.

Adverse Reactions

Clinical Trials Experience

  • In clinical trials, generally mild and transient burning and stinging followed application with permethrin 5% Cream in 10% of patients and was associated with the severity of infestation. Pruritus was reported in 7% of patients at various times post-application. Erythema, numbness, tingling, and rash were reported in 1 to 2% or less of patients.

Postmarketing Experience

  • Other adverse events reported since marketing Permethrin 5% Cream include: headache, fever, dizziness, abdominal pain, diarrhea and nausea and/or vomiting. Although extremely uncommon and not expected when used as directed , rare occurrences of seizure have been reported. None have been medically confirmed as associated with Permethrin™ treatment.

Drug Interactions

There is limited information regarding Drug Interactions of Permethrin in patients.

Use in Specific Populations

Pregnancy

Pregnancy Category (FDA): There is no FDA guidance on usage of Permethrin in women who are pregnant.
Pregnancy Category (AUS): There is no Australian Drug Evaluation Committee (ADEC) guidance on usage of Permethrin in women who are pregnant.

Labor and Delivery

There is no FDA guidance on use of Permethrin during labor and delivery.

Nursing Mothers

There is no FDA guidance on the use of Permethrin in women who are nursing.

Pediatric Use

There is no FDA guidance on the use of Permethrin in pediatric settings.

Geriatic Use

There is no FDA guidance on the use of Permethrin in geriatric settings.

Gender

There is no FDA guidance on the use of Permethrin with respect to specific gender populations.

Race

There is no FDA guidance on the use of Permethrin with respect to specific racial populations.

Renal Impairment

There is no FDA guidance on the use of Permethrin in patients with renal impairment.

Hepatic Impairment

There is no FDA guidance on the use of Permethrin in patients with hepatic impairment.

Females of Reproductive Potential and Males

There is no FDA guidance on the use of Permethrin in women of reproductive potentials and males.

Immunocompromised Patients

There is no FDA guidance one the use of Permethrin in patients who are immunocompromised.

Others

Administration and Monitoring

Administration

Topical

  • Shake bottle well prior to use.
  • Do not use near eyes, inside the nose, mouth, or vagina; protect eyes with a washcloth or towel during application.
  • (Permethrin 1%) apply to damp hair that has just been shampooed with a nonconditioning shampoo; saturate hair and scalp beginning behind the ears and at back of neck; leave on 10 minutes; rinse with warm water; remove nits with nit comb;
  • Repeat application if live lice present 7 days after initial treatment.
  • (Permethrin 1%) do not rewash hair for 1 to 2 days after treatment.
  • (Permethrin 5% cream) apply a generous amount of cream from head to feet, leave on for 8 to 14 hours, wash with soap/water, repeat application if living mites present 14 days after initial treatment.

Monitoring

  • Presence of lice

IV Compatibility

There is limited information regarding the compatibility of Permethrin and IV administrations.

Overdosage

  • No instance of accidental ingestion of Permethrin™ (permethrin) 5% Cream has been reported. If ingested, gastric lavage and general supportive measures should be employed. Excessive topical use may result in increased irritation and erythema.

Pharmacology

This image is provided by the National Library of Medicine.

Mechanism of Action

  • It acts on the nerve cell membrane to disrupt the sodium channel current by which the polarization of the membrane is regulated. Delayed repolarization and paralysis of the pests are the consequences of this disturbance.
  • Permethrin is rapidly metabolized by ester hydrolysis to inactive metabolites which are excreted primarily in the urine. Although the amount of permethrin absorbed after a single application of the 5% cream has not been determined precisely, data from studies with 14C-labeled permethrin and absorption studies of the cream applied to patients with moderate to severe scabies indicate it is 2% or less of the amount applied.

Structure

  • Permethrin™ (permethrin) 5% Cream is a topical scabicidal agent for the treatment of infestation with Sarcoptesscabiei (scabies). It is available in an off-white, vanishing cream base. Permethrin™ (permethrin) 5% Cream is for topical use only.
This image is provided by the National Library of Medicine.


Chemical Name - The permethrin used is an approximate 1:3 mixture of the cis and trans isomers of the pyrethroid 3-(2,2-dichloroethenyl)-2,2-dimethylcyclopropanecarboxylic acid, (3-phenoxyphenyl) methyl ester. Permethrin has a molecular formula of C21H20Cl2O3 and a molecular weight of 391.29. It is a yellow to light orange-brown, low melting solid or viscous liquid.

Active Ingredient - Each gram contains permethrin 50 mg (5%).

Inactive Ingredients - Butylated hydroxytoluene, carbomer homopolymer type B, fractionated coconut oil, glycerin, glyceryl monostearate, isopropyl myristate, lanolin alcohols, mineral oil, polyoxyethylene cetyl ethers, purified water, and sodium hydroxide. Formaldehyde 1 mg (0.1%) is added as a preservative.

Pharmacodynamics

There is limited information regarding Permethrin Pharmacodynamics in the drug label.

Pharmacokinetics

Absorption Topical: 2% or less absorbed.

Excretion

Topical: Renal.

Nonclinical Toxicology

There is limited information regarding Permethrin Nonclinical Toxicology in the drug label.

Clinical Studies

There is limited information regarding Permethrin Clinical Studies in the drug label.

How Supplied

Permethrin™ 5% Cream is available as follows:

60 g tube (NDC 40076-115-60)

Storage

  • Store at 20-25°C (68-77°F) [see USP Controlled Room Temperature].

Images

Drug Images

{{#ask: Page Name::Permethrin |?Pill Name |?Drug Name |?Pill Ingred |?Pill Imprint |?Pill Dosage |?Pill Color |?Pill Shape |?Pill Size (mm) |?Pill Scoring |?NDC |?Drug Author |format=template |template=DrugPageImages |mainlabel=- |sort=Pill Name }}

Package and Label Display Panel

{{#ask: Label Page::Permethrin |?Label Name |format=template |template=DrugLabelImages |mainlabel=- |sort=Label Page }}

Patient Counseling Information

There is limited information regarding Permethrin Patient Counseling Information in the drug label.

Precautions with Alcohol

Alcohol-Permethrin interaction has not been established. Talk to your doctor about the effects of taking alcohol with this medication.

Brand Names

Permethrin™

Look-Alike Drug Names

There is limited information regarding Permethrin Look-Alike Drug Names in the drug label.

Drug Shortage Status

Drug Shortage

Price

References

The contents of this FDA label are provided by the National Library of Medicine.

{{#subobject: 

 |Label Page=Permethrin
 |Label Name=Permethrin ingredients and appearance.png

}}

{{#subobject: 

 |Label Page=Permethrin
 |Label Name=Permethrin fig02.jpg

}}

{{#subobject: 

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